无托槽隐形矫治器治疗青少年下颌后缩型安氏Ⅱ类Ⅰ分类错效果评价

doi:10.19439/j.sjos.2024.06.017

摘要/Abstract

摘要： 目的: 探讨无托槽隐形矫治器在青少年下颌后缩型安氏Ⅱ类Ⅰ分类错矫治中的应用效果。方法: 收集2020年2月—2022年10月湖北省中医院收治的114例下颌后缩型安氏Ⅱ类Ⅰ分类错青少年患者的临床资料,根据矫治方法不同分为2组,每组57例。对照组采用Twin-block矫治器矫治,试验组采用无托槽隐形矫治器矫治。2组均矫治12个月,比较2组矫治效果、矫治前后龈沟液炎症因子[碱性磷酸酶（ALP）、基质金属蛋白酶8（MMP-8）、白介素1β（IL-1β）]水平、X线头影测量指标（SNB角、ANB角、Go-Gn、Ar-Go）、颞下颌关节参数（关节前间隙、关节后间隙、关节上间隙、关节窝高度）、上气道情况[鼻咽体积（V_鼻咽）、腭咽体积（V_腭咽）、舌咽体积（V_舌咽）]及矫治器佩戴主观感受评分。采用SPSS 28.0软件包对数据进行统计学分析。结果: 试验组矫治效果与对照组比较,差异无统计学意义（P>0.05）;矫治后试验组龈沟液IL-1β、MMP-8、ALP水平显著低于对照组（P<0.05）;矫治后2组SNB角、ANB角、Go-Gn、Ar-Go、关节前间隙、关节后间隙、关节上间隙、关节窝高度比较,差异无统计学意义（P>0.05）;矫治后2组V_舌咽、V_腭咽、V_鼻咽比较,差异无统计学意义（P>0.05）。试验组矫治器佩戴舒适性、依从性、美观度评分均显著高于对照组（P<0.05）。结论: 无托槽隐形矫治器和Twin-block矫治器治疗青少年下颌后缩型安氏Ⅱ类Ⅰ分类错患者效果相当,均能改善下颌形态及牙列形态,扩张上气道,而无托槽隐形矫治器能进一步减轻炎症,提高患者佩戴舒适度。

关键词: 安氏Ⅱ类Ⅰ分类错, 下颌后缩型, 青少年, 无托槽隐形矫治器, 上气道, 炎症因子, 颞下颌关节

Abstract: PURPOSE: To explore the application value of invisible orthodontic appliance without brackets in the correction of ClassⅡand ClassⅠmalocclusion in adolescents with mandibular recession. METHODS: A retrospective collection of clinical data was conducted on 114 adolescent patients with ClassⅡand ClassⅠmalocclusion of mandibular retrusion admitted to Hubei Hospital of Traditional Chinese Medicine from February 2020 to October 2022. They were divided into two groups based on different orthodontic methods, with 57 cases in each group. The control group was treated with Twin block appliances, while the experimental group was treated with invisible appliances without brackets. Both groups of patients were corrected for 12 months. The treatment effects of the two groups were evaluated, and the levels of inflammatory factors [alkaline phosphatase (ALP), matrix metalloproteinase-8 (MMP-8), interleukin-1β (IL-1β)] in gingival crevicular fluid before and after treatment, X-ray cephalometric indicators(SNB angle, ANB angle, Go-Gn, Ar-Go), temporomandibular joint parameters (anterior joint space, posterior joint space, superior joint space, fossa height) and upper airway conditions [nasopharyngeal volume (V-nasopharynx), velopharyngeal volume(V-velopharynx), glossopharyngeal volume (V-glossopharynx)], and the subjective perception scores of wearing orthodontic appliance were compared between the two groups. SPSS 28.0 software package was used for data analysis. RESULTS: There was no significant difference in the orthodontic outcome of the experimental group compared to the control group (P>0.05). After correction, the levels of IL-1β, MMP-8 and ALP in the gingival crevicular fluid were significantly lower in the experimental group compared to the control group(P<0.05), but there was no significant difference(P>0.05) between the two groups in terms of SNB angle, ANB angle, Go Gan, Ar Go, anterior and posterior joint spaces, supraarticular space, and joint socket height. After correction, there was no significant difference(P>0.05) between the two groups in V-glossopharynx, V-palatopharynx, and V-nasopharynx. The experimental group had significantly higher scores in terms of comfort, compliance, and aesthetics when wearing invisible orthodontic appliances without brackets compared to the control group(P<0.05). CONCLUSIONS: The treatment effect of Twin-block appliance and non-bracket invisible appliance is comparable for Class Ⅱ division Ⅰ malocclusion in adolescents with mandibular retrognathia. Both can improve the morphology of the mandible and dentition, expand the upper airway, but non-bracket invisible appliance can further reduce inflammation and improve patients' comfort.

Key words: ClassⅡ division Ⅰ malocclusion, Mandibular retrognathia, Teenagers, Invisible orthodontic appliances without brackets, Upper airway, Inflammatory factors, Temporomandibular joint

中图分类号:

R783.5

余姣, 王汉明, 朱晓密, 范志龙. 无托槽隐形矫治器治疗青少年下颌后缩型安氏Ⅱ类Ⅰ分类错效果评价[J]. 上海口腔医学, 2024, 33(6): 661-666.

YU Jiao, WANG Han-ming, ZHU Xiao-mi, FAN Zhi-long. Clinical study on the treatment of Class Ⅱ and ClassⅠmalocclusion in adolescents with mandibular recession using invisible orthodontic appliances without brackets[J]. Shanghai Journal of Stomatology, 2024, 33(6): 661-666.

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